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General NPI Number Information
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NPI Number | 1053665521
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Entity Type | Organization
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Legal Business Name | BC SURGICAL CENTER, INC.
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 1725 N UNIVERSITY DR
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City | PLANTATION
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State | FL
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Zip | 33322-4111
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Country | US
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Telephone | 954-474-8586
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Fax | 954-526-0865
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Provider Business Mailing Address
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Address Line | 1725 N UNIVERSITY DR
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City | PLANTATION
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State | FL
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Zip | 33322-4111
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Country | US
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Telephone | 954-474-8586
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Fax | 954-526-0865
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ISMAEL LABRADOR
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Credential | M.D.
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Telephone | 954-474-8586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ME 92214
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License Number State | FL
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